Fox Insurance's Medicare Part D Plan Suspended; 24,000 North Carolinians May be Affected

SHIIP staff available to help after Fox Insurance is ordered to stop ads and enrollment of Part D plan.

RALEIGH -- Insurance Commissioner Wayne Goodwin today announced that the Department's SHIIP program is available to help some 24,000 N.C. Medicare recipients who may be affected by Medicare's suspension of Fox Insurance Company of New York's marketing and enrollment of its Part D prescription drug plans.

"North Carolina has more than 24,000 Medicare recipients enrolled in a Fox Insurance Company Part D plan, and I want those folks to know that if they've had problems filling their prescriptions, our SHIIP program can help," said Commissioner Goodwin. "If your Medicare Part D plan is with Fox Insurance, and you're having problems getting your prescriptions call our SHIIP helpline at 1-800-443-9354."

Medicare identified that the company has not been able to meet the needs of its new members by failing to provide timely access to prescription drugs covered under the Part D plan. The company was requiring prior authorization and step therapy when filling prescriptions - requirements not approved by CMS (Centers for Medicare and Medicaid Services) - as well as not meeting the necessary appeals deadlines and requirements for transitioning new enrollees to the covered drugs.

According to CMS, the problems surrounding Fox could result in delays in therapies and prevent access to prescriptions - mostly involving drugs used for treatment of cancer, HIV/AIDS, seizure disorders, diabetes and respiratory disease - which would threaten members' safety and health. CMS fielded complaints from both Medicare recipients and their doctors about Fox; if the company fails to comply, it could face fines or termination of its Medicare contract.

Anyone with questions about this issue or any Medicare-related issue should contact SHIIP (Seniors' Health Insurance Information Program) at 1-800-443-9354.